There’s No Place Like Home for Hospice
A Philosophy of Care
One of the most common misconceptions about hospice is that it is an actual place patients go to die. The reality is that hospice is a philosophy of care that keeps seriously ill patients where they are most comfortable—home. The Medicare hospice benefit defines four levels of care every Medicare-certified hospice must offer:
Of these, routine home care is where almost 94 percent of all hospice services are provided, whether the patient’s home is a private residence, within an assisted living community or at a nursing home.¹
What Is Routine Home Care?
Faced with a life-limiting prognosis, some 90 percent of patients prefer to remain at home, surrounded by the people and things they love, continuing their routines.² Hospice ensures that those who wish to die at home can do so without pain, their symptoms under control, their dignity maintained. Most home care patients have a family caregiver with them. Trained professionals from a variety of disciplines augment that care with regular visits, guided by a plan of care.
With the assistance of this interdisciplinary hospice team—physician, registered nurse, hospice aide, social worker, chaplain, volunteer and bereavement specialist—the physical, spiritual and emotional needs of the patient and the family are met.
Routine home care includes:
- Pain and symptom management
- Giving medications
- Personal care
- Wound care
- Nutritional assistance
- Help with daily activities
- Emotional support
- Spiritual support
- Bereavement support
Family Members Are Part of the Care Team
The patient and family lead the interdisciplinary team in the development of the patient’s plan of care. The hospice team implements the plan and teaches family caregivers how to take care of the patient and what to look for as the patient’s condition changes. The individual members of the team schedule weekly visits and are always available—24/7, 365 days a year—to answer questions, lend support or make additional visits to the patient and family. The goal is to avoid trips to the emergency department or another hospitalization.
When Home is Not a House
Some patients call a nursing home or other residential care facility home. When this is the case, routine care takes place in the facility just as it is provided in a private residence. Instead of family members caring for the patient, the facility staff offers daily care. The patient still receives regular visits from each member of the team; the staff is instructed in the patient’s care just as a family member would be.
By treating physical symptoms, addressing pain and providing emotional and spiritual support, routine home care can make the last months and weeks of life more comfortable and meaningful for patients and their loved ones, wherever they call home.
¹NHPCO Facts and Figures on Hospice Care, 2015, page 11, Table 11.
² When There's a Serious Illness, There's No Place Like Home